Tissue resecting instrument including an outflow control seal

ABSTRACT

A tissue resecting end effector includes a housing, a shaft extending from the housing, and a drive assembly operably coupled to the shaft such that a rotational input provided to the drive assembly effects the rotation and reciprocation of the shaft relative to the housing. The assembly includes a proximal portion translationally fixed and rotatably coupled to the housing and configured to receive the rotational input and to rotate relative to the housing in response thereto, a distal portion translationally and rotatably coupled to the housing and operably coupled to the proximal portion such that the rotation of the proximal portion relative to the housing effects rotation and reciprocation of the distal portion relative to the housing to thereby rotate and reciprocate the first shaft relative to the housing, and a seal member disposed on the proximal portion or the distal portion and configured to selectively establish a seal therebetween.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/409,977, filed on May 13, 2019, which is a continuation-in-part ofU.S. patent application Ser. No. 16/282,417, filed on Feb. 22, 2019, nowU.S. Pat. No. 11,083,481, the entire contents of each of which arehereby incorporated herein by reference.

FIELD

The present disclosure relates generally to the field of tissueresection. In particular, the present disclosure relates to a tissueresecting instrument including an outflow control seal.

BACKGROUND

Tissue resection may be performed endoscopically within an organ, suchas a uterus, by inserting an endoscope (or hysteroscope) into the uterusand passing a tissue resection instrument through the endoscope (orhysteroscope) and into the uterus. With respect to such endoscopictissue resection procedures, it often is desirable to distend the uteruswith a fluid, for example, saline, sorbitol, or glycine. The inflow andoutflow of the fluid during the procedure maintains the uterus in adistended state and flushes tissue and other debris from within theuterus to maintain a visible working space.

SUMMARY

As used herein, the term “distal” refers to the portion that isdescribed which is further from a user, while the term “proximal” refersto the portion that is described which is closer to a user. Further, tothe extent consistent, any or all of the aspects described herein may beused in conjunction with any or all of the other aspects describedherein.

Provided in accordance with aspects of the present disclosure is an endeffector assembly of a tissue resecting instrument. The end effectorassembly includes a proximal hub housing, an outer shaft extending fromthe proximal hub housing, an inner shaft disposed within the outer shaftand configured to rotate and reciprocate relative to the outer shaft forcutting tissue, and an inner core drive assembly disposed at leastpartially within the proximal hub housing. The inner core drive assemblyis operably coupled to the inner shaft and configured such that arotational input provided to the inner core drive assembly effects therotation and reciprocation of the inner shaft relative to the outershaft. The inner core drive assembly includes a proximal receiverconfigured to receive the rotational input and to rotate relative to theproximal hub housing in response thereto. The proximal receiver includesa seal member disposed thereon. The inner core drive assembly furtherincludes a connector operably coupled to the proximal receiver such thatthe rotation of the proximal receiver effects rotation of the connectorrelative to the proximal hub housing and reciprocation of the connectorrelative to the proximal receiver and the proximal hub housing between aproximal position and a distal position. The connector is operablycoupled to the inner shaft such that the rotation and reciprocation ofthe connector effects the rotation and reciprocation of the inner shaft.The connector defines a cavity disposed in fluid communication with aninterior of the inner shaft. In the proximal position, the connectorabuts the seal member to establish a seal that blocks outflow from thecavity. In the distal position, the connector is displaced from the sealmember to permit outflow from the cavity.

In an aspect of the present disclosure, the inner core drive assemblyfurther includes a threaded coupler operably coupled to the connectorand a follower operably engaged with the threaded coupler. The rotationof the connector in response to the rotation of the proximal receiverrotates the threaded coupled relative to the follower, therebyreciprocating the threaded coupler and the connector relative to theproximal receiver.

In another aspect of the present disclosure, the connector isrotationally fixed relative to the proximal receiver via at leastpartial receipt of a distal spine of the proximal receiver within thecavity of the connector.

In another aspect of the present disclosure, the distal spine isslidable relative to the cavity of the connector to permit thereciprocation of the connector relative to the proximal receiver.

In still another aspect of the present disclosure, the seal member isdisposed about the distal spine.

In yet another aspect of the present disclosure, the reciprocation ofthe connector effects similar reciprocation of the inner shaft.

In still yet another aspect of the present disclosure, gearing isoperably coupled between the connector and the inner shaft such that therotation of the inner shaft is amplified or attenuated relative to therotation of the connector.

In another aspect of the present disclosure, the outer shaft defines awindow and the inner shaft is configured to rotate and reciprocaterelative to the window to cut tissue extending through the window.

In yet another aspect of the present disclosure, the proximal positionof the connector corresponds to a proximal position of the inner shaftrelative to the outer shaft.

A tissue resecting instrument provided in accordance with aspects of thepresent disclosure includes a handpiece assembly including a drive rotorand an outflow conduit, and an end effector assembly configured toreleasably engage the handpiece assembly. The end effector assemblyincludes an outer shaft, an inner shaft disposed within the outer shaftand configured to rotate and reciprocate relative to the outer shaft forcutting tissue, and an inner core drive assembly. The inner core driveassembly includes a proximal receiver configured to receive a rotationalinput from the drive rotor and to rotate in response thereto. Theproximal receiver includes a seal member disposed thereon. The innercore drive assembly further includes a connector operably coupled to theproximal receiver such that the rotation of the proximal receivereffects rotation of the connector and reciprocation of the connectorbetween a proximal position and a distal position. The connector isoperably coupled to the inner shaft such that the rotation andreciprocation of the connector effects the rotation and reciprocation ofthe inner shaft. The connector defines a cavity disposed in fluidcommunication with an interior of the inner shaft. In the proximalposition, the connector abuts the seal member to establish a seal thatblocks outflow from the cavity into the outflow conduit. In the distalposition, the connector is displaced from the seal member to permitoutflow from the cavity into the outflow conduit.

In an aspect of the present disclosure, the handpiece assembly furtherincludes a motor configured to drive rotation of the drive rotor.

In another aspect of the present disclosure, the inner core driveassembly further includes a threaded coupler operably coupled to theconnector and a follower operably engaged with the threaded coupler. Therotation of the connector in response to the rotation of the proximalreceiver rotates the threaded coupled relative to the follower, therebyreciprocating the threaded coupler and the connector relative to theproximal receiver.

In still another aspect of the present disclosure, the connector isrotationally fixed relative to the proximal receiver via at leastpartial receipt of a distal spine of the proximal receiver within thecavity of the connector. In such aspects, the distal spine may beslidable relative to the cavity of the connector to permit thereciprocation of the connector relative to the proximal receiver.Additionally or alternatively, the seal member is disposed about thedistal spine.

In yet another aspect of the present disclosure, wherein thereciprocation of the connector effects similar reciprocation of theinner shaft.

In still yet another aspect of the present disclosure, gearing isoperably coupled between the connector and the inner shaft such that therotation of the inner shaft is amplified or attenuated relative to therotation of the connector.

In another aspect of the present disclosure, the outer shaft defines awindow and the inner shaft is configured to rotate and reciprocaterelative to the window to cut tissue extending through the window.

In an aspect of the present disclosure, the proximal position of theconnector corresponds to a proximal position of the inner shaft relativeto the outer shaft.

In another aspect of the present disclosure, the drive rotor isconfigured to provide a further rotational input to the proximalreceiver after the rotational input to the proximal receiver to returnthe connector to the proximal position, thereby establishing the sealthat blocks outflow from the cavity into the outflow conduit.

Also provided in accordance with aspects of the present disclosure is anend effector assembly of a tissue resecting instrument that includes ahousing, a first shaft extending from the housing and configured torotate and reciprocate relative to the housing to cut tissue, and aninner core drive assembly disposed at least partially within thehousing. The inner core drive assembly is operably coupled to the firstshaft and configured such that a rotational input provided to the innercore drive assembly effects the rotation and reciprocation of the firstshaft relative to the housing. The inner core drive assembly includes aproximal portion, a distal portion, and a seal member. The proximalportion is translationally fixed and rotatably coupled to the housingand configured to receive the rotational input and to rotate relative tothe housing in response thereto. The distal portion is translationallyand rotatably coupled to the housing and operably coupled to theproximal portion such that the rotation of the proximal portion relativeto the housing effects rotation and reciprocation of the distal portionrelative to the housing to thereby rotate and reciprocate the firstshaft relative to the housing. The seal member is disposed on one of theproximal portion or the distal portion. In at least one firsttranslational position of the distal portion relative to the proximalportion, the seal member establishes a seal between the proximal anddistal portions to inhibit fluid flow therebetween. In at least onesecond position of the distal portion relative to the proximal portion,the seal member is displaced to permit fluid flow between the proximaland distal portions.

In an aspect of the present disclosure, the seal member is disposed onthe proximal portion such that the distal portion reciprocates relativeto the seal member. Alternatively, the seal member is disposed on thedistal portion such that the seal member reciprocates relative to theproximal portion.

In another aspect of the present disclosure, a second shaft is fixedrelative to and extends distally from the housing. In such aspects, thefirst shaft is translationally and rotatably disposed within the secondshaft.

In yet another aspect of the present disclosure, an end face of the sealmember is configured to establish the seal.

In still another aspect of the present disclosure, an outer periphery ofthe seal member is configured to establish the seal.

Another end effector assembly of a tissue resecting instrument providedin accordance with aspects of the present disclosure includes a housing,a first shaft extending from the housing and configured to rotate andreciprocate relative to the housing to cut tissue, and an inner coredrive assembly disposed at least partially within the housing. The innercore drive assembly is operably coupled to the first shaft andconfigured such that a rotational input provided to the inner core driveassembly effects the rotation and reciprocation of the first shaftrelative to the housing. The inner core drive assembly includes aproximal portion translationally fixed and rotatably coupled to thehousing. The proximal portion is configured to receive the rotationalinput and to rotate relative to the housing in response thereto. Theinner core drive assembly further includes a distal portiontranslationally and rotatably coupled to the housing and operablycoupled to the proximal portion such that the rotation of the proximalportion relative to the housing effects rotation and reciprocation ofthe distal portion relative to the housing to thereby rotate andreciprocate the first shaft relative to the housing. The inner coredrive assembly also includes a seal member disposed on the distalportion and slidably received within the proximal portion. In at leastone first translational position of the distal portion relative to theproximal portion, the seal member establishes a seal about an innersurface of the proximal portion to inhibit fluid flow therebetween. Inat least one second position of the distal portion relative to theproximal portion, the seal member is displaced to permit fluid flowbetween the proximal and distal portions.

In an aspect of the present disclosure, the proximal portion includes anextension having a first section defining plurality oflongitudinally-extending slots configured to permit passage of fluidtherethrough and a second section devoid of longitudinally-extendingslots.

In another aspect of the present disclosure, in the at least one firsttranslational position, the seal member is positioned within the firstsection of the extension of the proximal portion. In the at least onesecond position, the seal member is positioned within the second sectionof the extension of the proximal portion.

In still another aspect of the present disclosure, the at least onefirst translational position corresponds to a more-distal position ofthe distal portion relative to the proximal portion and the at least onesecond translational position corresponds to a more-proximal position ofthe distal portion relative to the proximal portion.

In yet another aspect of the present disclosure, a second shaft is fixedrelative to and extends distally from the housing. The first shaft, insuch aspects, is translationally and rotatably disposed within thesecond shaft. Further, the second shaft may define a window wherein thefirst shaft is configured to rotate and reciprocate relative to thewindow to cut tissue extending through the window.

A tissue resecting instrument provided in accordance with aspects of thepresent disclosure includes a handpiece assembly including a drive rotorand an outflow conduit and an end effector assembly configured toreleasably engage the handpiece assembly. The end effector assembly maybe provided in accordance with any of the aspects detailed above.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects and features of the present disclosure are describedhereinbelow with reference to the drawings wherein like numeralsdesignate identical or corresponding elements in each of the severalviews.

FIG. 1 is a side view of a tissue resecting instrument provided inaccordance with aspects of the present disclosure including a handpieceassembly and an end effector assembly, wherein a distal end portion ofthe end effector assembly is enlarged to better illustrate featuresthereof;

FIG. 2 is a perspective view of the end effector assembly of the tissueresecting instrument of FIG. 1 ;

FIG. 3 is a longitudinal, cross-sectional view of the end effectorassembly of FIG. 2 ;

FIG. 4 is a longitudinal, cross-sectional view of a portion of thetissue resecting instrument of FIG. 1 with the end effector assemblyoperably coupled to a drive rotor of the handpiece assembly and fluidlycoupled to an outflow conduit of the handpiece assembly, wherein theremainder of the handpiece assembly is removed;

FIG. 5 is a longitudinal, cross-sectional view of the portion of thetissue resecting instrument of FIG. 1 illustrated in FIG. 4 , with theend effector assembly operably coupled to the drive rotor of thehandpiece assembly and sealed from the outflow conduit of the handpieceassembly, wherein the remainder of the handpiece assembly is removed;

FIG. 6 is a front view of a seal member of the end effector assembly ofFIG. 2 ;

FIG. 7 is a side view of the seal member of FIG. 6 ;

FIG. 8 is a longitudinal, cross-sectional view taken across section line“8-8” of FIG. 6 ;

FIG. 9 is a front view of another seal member configured for use withthe end effector assembly of FIG. 2 ;

FIG. 10 is a side view of the seal member of FIG. 9 ;

FIG. 11 is a rear view of the seal member of FIG. 9 ;

FIG. 12 is a longitudinal, cross-sectional view taken across sectionline “12-12” of FIG. 10 ;

FIG. 13 is a longitudinal, cross-sectional view of a portion of anothertissue resecting instrument provided in accordance with the presentdisclosure with an end effector assembly operably coupled to a driverotor of a handpiece assembly and fluidly coupled to an outflow conduitof the handpiece assembly, wherein the remainder of the handpieceassembly is removed; and

FIG. 14 is a longitudinal, cross-sectional view of the portion of thetissue resecting instrument illustrated in FIG. 13 , with the endeffector assembly operably coupled to the drive rotor of the handpieceassembly and sealed from the outflow conduit of the handpiece assembly,wherein the remainder of the handpiece assembly is removed.

DETAILED DESCRIPTION

Referring generally to FIG. 1 , a tissue resecting instrument 10provided in accordance with the present disclosure and configured toresect tissue includes an end effector assembly 100 and a handpieceassembly 200. Tissue resecting instrument 10 is adapted to connect to acontrol unit (not shown) via a cable 300 to provide power and controlfunctionality to tissue resecting instrument 10, although tissueresecting instrument 10 may alternatively or additionally includecontrols associated with handpiece assembly 200 and/or a power source,e.g., battery, disposed within handpiece assembly 200. Tissue resectinginstrument 10 is further adapted to connect to a fluid management system(not shown) via outflow tubing 400 for applying suction to remove fluid,tissue, and debris from a surgical site via tissue resecting instrument10, as detailed below. The control unit and fluid management system maybe integral with one another, coupled to one another, or separate fromone another.

Tissue resecting instrument 10 may be configured as a single-use devicethat is discarded after use or sent to a manufacturer for reprocessing,a reusable device capable of being cleaned and/or sterilized forrepeated use by the end-user, or a partially-single-use,partially-reusable device. With respect to partially-single-use,partially-reusable configurations, handpiece assembly 200 may beconfigured as a cleanable/sterilizable, reusable component, while endeffector assembly 100 is configured as a single-use,disposable/reprocessable component. In any of the above configurations,end effector assembly 100 is configured to releasably engage handpieceassembly 200 to facilitate disposal/reprocessing of any single-usecomponents and cleaning and/or sterilization of any reusable components.Further, enabling releasable engagement of end effector assembly 100with handpiece assembly 200 allows for interchangeable use of differentend effector assemblies, e.g., different length, configuration, etc.,end effector assemblies, with handpiece assembly 200.

Continuing with reference to FIG. 1 , handpiece assembly 200 generallyincludes a handle housing 210, an outflow conduit 220 defined through(as shown), extending through, disposed on, or otherwise associated withhandle housing 210, a motor 250 disposed within handle housing 210, anda drive rotor 260 disposed at least partially within handle housing 210and operably coupled to motor 250. Handpiece assembly 200 may furtherinclude one or more controls (not shown) disposed on or operablyassociated with handle housing 210 to facilitate activation of tissueresecting instrument 10. Further, outflow tubing 400 is configured toconnect to a proximal end portion of outflow conduit 220 to therebyconnect outflow conduit 220 to the fluid management system (not shown).The fluid management system includes a vacuum source to establishsuction through tissue resecting instrument 10 and outflow tubing 400 tofacilitate removal of fluid, tissue, and debris from the surgical siteand may also include a collection reservoir, e.g., a collectioncanister, for collecting the removed fluid, tissue, and debris. As analternative or in addition to a vacuum source establishing suctionthrough tissue resecting instrument 10 and outflow tubing 400, vacuummay be created therethrough via a pressure differential between thesurgical site and the outflow path.

Handle housing 210 defines a pencil-grip configuration, although otherconfigurations are also contemplated, e.g., pistol-grip configurations,and includes a distal hub 212 disposed at an open distal end portion 214thereof. Distal hub 212 defines an annular recess 216 configured tofacilitate releasably engagement of end effector assembly 100 withhandpiece assembly 200, as detailed below. Open distal end portion 214of handle housing 210 provides access to drive rotor 260 and a distalend portion of outflow conduit 220 within handle housing 210 such that,upon engagement of end effector assembly 100 with handpiece assembly200, as also detailed below, a portion of end effector assembly 100extends through open distal end portion 214 and into the interior ofhandle housing 210 to operably couple with drive rotor 260 and a distalend portion of outflow conduit 220.

Cable 300 extends proximally from handle housing 210 and is configuredto connect to the control unit (not shown) to provide power and controlfunctionality to tissue resecting instrument 10. Cable 300, morespecifically, houses one or more wires 310 that extend into handlehousing 210 and connect to the controls thereof and/or motor 250 topower motor 250 and control operation of tissue resecting instrument 10in accordance with controls associated with handpiece assembly 200, thecontrol unit, and/or other remote control devices, e.g., a footswitch(not shown).

Drive rotor 260 is operably coupled with and extends distally from motor250 such that, upon activation of motor 250, motor 250 drives rotationof drive rotor 260. At least a portion of drive rotor 260 defines anon-circular cross-sectional configuration, e.g., a square or otherpolygonal configuration. Drive rotor 260 is configured for at leastpartial receipt within proximal receiver 146 of end effector assembly100 (see FIG. 2 ) in fixed rotational orientation relative thereto uponengagement of end effector assembly 100 with handpiece assembly 200. Assuch, activation of motor 250 drives rotation of drive rotor 260 to, inturn, drive rotation of inner cutting shaft 130 of end effector assembly100, as detailed below.

Referring to FIGS. 1-3 , end effector assembly 100 includes a proximalhub housing 110, an elongated outer shaft 120 monolithically formed,fixedly engaged, or otherwise connected with and extending distally fromproximal hub housing 110, an inner cutting shaft 130 disposed withinelongated outer shaft 120, and an inner core drive assembly 140.

Proximal hub housing 110 of end effector assembly 100 includes a distalbody portion 112 and a proximal extension portion 114 that may bemonolithically formed, engaged, or otherwise connected to one another.With end effector assembly 100 engaged with handpiece assembly 200,proximal extension portion 114 of proximal hub housing 110 extends intohandle housing 210 of handpiece assembly 200 while distal body portion112 substantially abuts and extends distally from handle housing 210 ofhandpiece assembly 200. An engagement lever 116 extends from proximalhub housing 110. Engagement lever 116 includes a finger tab 117 a and anengagement tooth 117 b disposed on opposite sides of a living hingepivot 117 c such that urging finger tab 117 a towards proximal hubhousing 110 urges engagement tooth 117 b away from proximal hub housing110, and vice versa.

Upon insertion of proximal extension portion 114 of proximal hub housing110 of end effector assembly 100 into handle housing 210 of handpieceassembly 200, engagement tooth 117 b is configured to cam over distalhub 212 of handpiece assembly 200 and into engagement within annularrecess 216 of distal hub 212 of handpiece assembly 200 to engage endeffector assembly 100 and handpiece assembly 20 with one another.Disengagement of end effector assembly 100 from handpiece assembly 200is effected by depressing finger tab 117 a towards proximal hub housing110 to thereby withdraw engagement tooth 117 b from annular recess 216.With engagement tooth 117 b disengaged from annular recess 216, endeffector assembly 100 may be moved distally relative to handpieceassembly 200 to withdraw proximal extension portion 114 from handlehousing 210, thereby disengaging end effector assembly 100 fromhandpiece assembly 200.

With reference to FIG. 1 , elongated outer shaft 120 of end effectorassembly 100, as noted above, includes a proximal end portion 122fixedly engaged with distal body portion 112 of proximal hub housing 110(see FIG. 3 ). Elongated outer shaft 120 further includes a distal endportion 124 defining a closed distal end 126 and a window 128proximally-spaced from closed distal end 126. Window 128 provides accessto the interior of elongated outer shaft 120 and may be surrounded by acutting edge 129 about the outer perimeter of window 128 so as tofacilitate cutting of tissue passing through window 128 and intoelongated outer shaft 120.

Inner cutting shaft 130 of end effector assembly 100 extends throughelongated outer shaft 120 and defines a proximal end portion 132 and adistal end portion 134 defining an open distal end 136. Proximal endportion 132 of inner cutting shaft 130 is operably coupled with innercore drive assembly 140, as detailed below (see FIG. 3 ). Inner cuttingshaft 130 defines an annular cutting edge 138 surrounding open distalend 136 so as to facilitate cutting of tissue passing into inner cuttingshaft 130 via open distal end 136. Inner cutting shaft 130 is rotatableand reciprocatable within and relative to elongated outer shaft 120.More specifically, inner cutting shaft 130 is configured to reciprocateand rotate such that annular cutting edge 138 is exposed within window128 of elongated outer shaft 120 during at least a portion of thereciprocation motion of inner cutting shaft 130 to enable cutting oftissue therewith. As detailed below, suction is provided to facilitatedrawing tissue into window 128 of elongated outer shaft 120 and, thus,to facilitate the cutting of tissue with inner cutting shaft 130 andremoval of tissue through inner cutting shaft 130. Other suitableconfigurations of elongated outer shaft 120 and/or inner cutting shaft130 that cooperate to facilitate tissue cutting are also contemplated.

Referring to FIGS. 2 and 3 , inner core drive assembly 140 is partiallydisposed within proximal hub housing 110 and extends proximally fromproximal hub housing 110 to facilitate operable engagement withhandpiece assembly 200. Further, inner core drive assembly 140 iscoupled to inner cutting shaft 130 within proximal hub housing 110 suchthat rotational input imparted to inner core drive assembly 140, e.g.,via handpiece assembly 200, drives reciprocation and rotation of innercutting shaft 130 within and relative to elongated outer shaft 120, asdetailed below.

Inner core drive assembly 140, more specifically, includes a ferrule 142fixedly engaged about proximal end portion 132 of inner cutting shaft130, a threaded coupler 144, a proximal receiver 146, and a connector148 operably coupling ferrule 142, threaded coupler 144, and proximalreceiver 146 with one another, as detailed below. Inner core driveassembly 140 further includes a follower 150 fixed relative to proximalhub housing 110. Follower 150 includes a cap 152 fixedly engaged withproximal hub housing 110 and an arm 154 extending from cap 152 intooperable engagement with helical channel 145 of threaded coupler 144.

Continuing with reference to FIGS. 2 and 3 , proximal receiver 146 ofinner core drive assembly 140 includes a proximally-facing cavity 147 aat least a portion of which has a non-circular cross-sectionalconfiguration, e.g., an 8-point star or other polygonal configuration,that is configured to at least partially receive drive rotor 260 ofhandpiece assembly 200 in fixed rotational orientation (see FIGS. 4 and5 ). Proximal receiver 146 further includes a central collar 147 breceived within an interior annular recess 115 defined within proximalextension portion 114 of proximal hub housing 110 to longitudinallyfixed and rotatably couple proximal receiver 146 relative to proximalhub housing 110. Proximal receiver 146 additionally includes a distalspine 147 c extending distally from central collar 147 b and a sealmember 160 engaged about distal spine 147 c. At least a portion ofdistal spine 147 c defines a non-circular cross-sectional configuration,e.g., a rectangular or other polygonal configuration.

Connector 148 defines a proximally-facing cavity 149 a at least aportion of which has a non-circular cross-sectional configuration, e.g.,a rectangular or other polygonal configuration, that is configured toreceive at least a portion of distal spine 147 c of proximal receiver146 in fixed rotational orientation while permitting relativetranslation therebetween. Connector 148 additionally includes anannular, proximally-facing surface 149 b surrounding proximally-facingcavity 149 a. Proximally-facing surface 149 b may be a substantiallyflat, smooth surface to facilitate establishing a fluid-tight sealbetween proximally-facing surface 149 b and seal member 160, as detailedbelow. Connector 148 further includes a distal body 149 c that isfixedly engaged with threaded coupler 144 and operably engaged withferrule 142 to thereby translationally fix and rotationally coupleconnector 148 and threaded coupler 144 with inner cutting shaft 130.Distal body 149 c of connector 148, more specifically, is operablyengaged with ferrule 142 via gearing 143 to amplify or attenuate therotational input to inner cutting shaft 130 relative to the rotationoutput from drive rotor 260. Alternatively, distal body 149 c ofconnector 148 may be fixedly engaged about ferrule 142 (or operablycoupled via a 1:1 gear ratio or other suitable 1:1 input to outputratio) such that the rotation imparted to inner cutting shaft 130 isequal to the rotational output from drive rotor 260. In eitherconfiguration, ferrule 142 and connector 148 are positioned relative toproximal end portion 132 of inner cutting shaft 130 such thatproximally-facing cavity 149 a of connector 148 is disposed in fluidcommunication with the interior of inner cutting shaft 130 via the openproximal end of inner cutting shaft 130.

Turning to FIGS. 4 and 5 , in use, motor 250 of handpiece assembly 200(see FIG. 1 ) is activated to drive rotation of drive rotor 260. Uponactivation of motor 250 (FIG. 1 ), with a head-start or delay relativeto activation of motor 250, or independently thereof, suction isestablished through outflow conduit 220 of handpiece assembly 200 andoutflow tubing 400, e.g., via activating the vacuum source of the fluidmanagement system.

Due to the fixed rotational engagement of drive rotor 260 at leastpartially within proximally-facing cavity 147 a of proximal receiver 146of inner core drive assembly 140, rotation of drive rotor 260 effectssimilar rotation of proximal receiver 146. Rotation of proximal receiver146 relative to proximal hub housing 110, in turn, is transmitted toconnector 148 via the fixed rotational engagement of distal spine 147 cof proximal receiver 146 at least partially within proximally-facingcavity 149 a of connector 148. This rotation imparted to connector 148,in turn, is transmitted to threaded coupler 144 via the fixed engagementof distal body 149 c of connector 148 therewith.

Further, due to the operable engagement of arm 154 of follower 150within helical channel 145 of threaded coupler 144, the impartedrotation to threaded coupler 144 reciprocates threaded coupler 144 and,thus, also reciprocates connector 148 relative to proximal hub housing110 and proximal receiver 146 (whereby distal spine 147 c of proximalreceiver 146 reciprocates within proximally-facing cavity 149 a ofconnector 148). The reciprocation and rotation of threaded coupler 144and connector 148 is also transmitted to inner cutting shaft 130 by wayof gearing 143 and ferrule 142 such that inner cutting shaft 130 isrotated and reciprocated within and relative to elongated outer shaft120. While gearing 143 may vary the rotation of inner cutting shaft 130relative to threaded coupler 144 and connector 148, inner cutting shaft130 is reciprocated similarly as threaded coupler 144 and connector 148.

With additional reference to FIG. 1 , while motor 250 is active,threaded coupler 144 and connector 148 are rotated and reciprocated toeffect rotation and reciprocation of inner cutting shaft 130. Withrespect to reciprocation in particular, inner cutting shaft 130,threaded coupler 144, and connector 148 are repeatedly reciprocated fromrespective proximal-most positions to respective distal-most positionsand back to the respective proximal-most positions.

When connector 148 is displaced from the proximal-most position thereof,as illustrated in FIG. 4 , proximally-facing surface 149 b of connector148 is spaced-apart from seal member 160 and, thus, proximally-facingcavity 149 a of connector 148, which is disposed in fluid communicationwith the interior of inner cutting shaft 130, is also disposed in fluidcommunication with outflow conduit 220 of handpiece assembly 200 suchthat suction applied through outflow conduit 220 establishes vacuumwithin inner cutting shaft 130 to draw tissue through window 128 ofelongated outer shaft 120 and into inner cutting shaft 130, whilecutting edges 129, 138 facilitate cutting of tissue as it passes throughwindow 128 and into inner cutting shaft 130. The cut tissue, fluids, anddebris are suctioned through inner cutting shaft 130, proximally-facingcavity 149 a of connector 148, outflow conduit 220 of handpiece assembly200, and outflow tubing 400 to the collection reservoir.

However, when connector 148 is disposed in the proximal-most positionthereof, as illustrated in FIG. 5 , proximally-facing surface 149 b ofconnector 148 is sealingly engaged with seal member 160, thus sealingproximally-facing cavity 149 a of connector 148 from outflow conduit 220of handpiece assembly 200 and inhibiting fluid communicationtherebetween. Thus, in the proximal-most position of connector 148, nosuction is applied through inner cutting shaft 130.

The proximal-most position of connector 148 illustrated in FIG. 5 (whichalso corresponds to the proximal-most position of threaded coupler 144and inner cutting shaft 130), wherein proximally-facing surface 149 b ofconnector 148 is sealingly engaged with seal member 160, may correspondto an initial and/or home position of end effector assembly 100. Morespecifically, end effector assembly 100 may initially be disposed withconnector 148 in its proximal-most position prior to engagement of endeffector assembly 100 with handpiece assembly 200. Thus, upon engagementof end effector assembly 100 with handpiece assembly 200,proximally-facing cavity 149 a of connector 148 is sealed off fromoutflow conduit 220 of handpiece assembly 200. Further, this initialposition may be designated as a home position, whereby a control program(not shown) associated with motor 250 records the rotational position ofdrive rotor 260 upon engagement of end effector assembly 100 withhandpiece assembly 200 (see FIG. 1 ) and, after activation, ensures thatdrive rotor 260 stops at a rotational position corresponding to theproximal-most position of connector 148 and, thus, a position whereproximally-facing cavity 149 a of connector 148 is sealed off fromoutflow conduit 220 of handpiece assembly 200.

The control program may utilize correlation information correlating, forexample, rotation of drive rotor 260 with reciprocation of connector 148to ensure that connector 148 is returned to its proximal-most positionafter each activation. As the correlating information may vary dependingupon the particular end effector assembly 100 utilized, the controlprogram may communicate with or read information from end effectorassembly 100 in order to correlate rotation of drive rotor 260 withreciprocation of connector 148 and, thus, set the home position.

Turning to FIGS. 6-8 , seal member 160 is shown. Other suitable sealmembers configured for use with tissue resecting instrument 10 (FIG. 1 )are also contemplated such as, for example, seal member 1160 (FIGS. 9-12). Seal member 160 includes a generally cylindrical body 162, a proximalrim 164 protruding radially outwardly from body 162, and a distal rim166 protruding radially outwardly from body 162 at a positionspaced-apart relative to proximal rim 164. Seal member 160 may bemonolithically formed, e.g., molded, from any suitable material, e.g.,silicone, rubber, PTFE, etc.

With additional reference to FIGS. 4 and 5 , body 162 defined alongitudinal lumen 163 extending therethrough that is configured toreceive distal spine 147 c of proximal receiver 146 to secure sealmember 160 about distal spine 147 c. Distal rim 166 defines adistally-facing seal surface 167 and is configured to establish a sealagainst proximally-facing surface 149 b of connector 148, in response toproximal-urging of proximally-facing surface 149 b into contact withdistally-facing seal surface 167, e.g., in the proximal-most position ofconnector 148 (see FIG. 5 ). In this manner, distal rim 166 functions asa face seal. An outer periphery 165 of proximal rim 164, on the otherhand, is configured to sealingly engage an interior surface of proximalextension portion 114 of proximal hub housing 110 to inhibit any fluidsdisposed within proximal extension portion 114 of proximal hub housing110 from passing proximally beyond seal member 160 and to inhibit fluidproximally of seal member 160 (but outside the outflow path) from beingsuctioned into the outflow path. Proximal rim 164 is configured as adynamic seal in that outer periphery 165 thereof maintains a seal withthe interior surface of proximal extension portion 114 of proximal hubhousing 110 throughout rotation of distal spine 147 c and, thus, sealmember 160 relative to proximal extension portion 114 of proximal hubhousing 110. Accordingly, seal member 160 provides a dual-sealconfiguration.

Turning to FIGS. 9-12 , another seal member 1160 configured for use withtissue resecting instrument 10 (FIG. 1 ) is shown. Seal member 1160includes a generally cylindrical body 1162 defining a proximal endportion 1163, a distal end portion 1165, and a lumen 1166 extendinglongitudinally therethrough. Distal end portion 1165 of seal member 1160is inverted outwardly and back onto the exterior of body 1162 to definea distally-facing surface 1168 a and a radially-outwardly-facing surface1168 b.

With additional reference to FIGS. 4 and 5 , body 1162 is configured forpositioning about distal spine 147 c of proximal receiver 146 (withdistal spine 147 c extending through lumen 1166) to secure seal member1160 about distal spine 147 c. Distally-facing surface 1168 a isconfigured to establish a seal against proximally-facing surface 149 bof connector 148, in response to proximal-urging of proximally-facingsurface 149 b into contact with distally-facing seal surface 1168 a,e.g., in the proximal-most position of connector 148 (see FIG. 5 ). Inthis manner, distally-facing surface 1168 a functions as a face seal.Radially-outwardly-facing surface 1168 b, on the other hand, isconfigured to sealingly engage an interior surface of proximal extensionportion 114 of proximal hub housing 110 to inhibit any fluids disposedwithin proximal extension portion 114 of proximal hub housing 110 frompassing proximally beyond seal member 1160 and to inhibit fluidproximally of seal member 1160 (but outside the outflow path) from beingsuctioned into the outflow path. Radially-outwardly-facing surface 1168b is configured as a dynamic seal that is configured to maintain a sealwith the interior surface of proximal extension portion 114 of proximalhub housing 110 throughout rotation of distal spine 147 c and, thus,seal member 1160 relative to proximal extension portion 114 of proximalhub housing 110. Accordingly, seal member 1160 provides a dual-sealconfiguration.

Turning to FIGS. 13 and 14 , a portion of another tissue resectinginstrument provided in accordance with the present disclosure andconfigured to resect tissue is shown generally identified by referencenumeral 2010. Tissue resecting instrument 2010 includes an end effectorassembly 2100 and a handpiece assembly 2200 and is similar to and mayinclude any of the features of tissue resecting instrument 10 (FIG. 1 )detailed above, except as explicitly contradicted below. For purposes ofbrevity, only the differences between tissue resecting instrument 2010and tissue resecting instrument 10 (FIG. 1 ) are described in detailbelow while similarities are summarily described or omitted entirely.

Handpiece assembly 2200 of tissue resecting instrument 2010 includes anoutflow conduit 2220 configured to fluidly couple with end effectorassembly 2100 upon engagement of handpiece assembly 2200 with endeffector assembly 2100. Handpiece assembly 2200 also includes a driverotor 2260 operably coupled to a motor (not shown) and extendingdistally from the motor.

End effector assembly 2100 of tissue resecting instrument 2010 includesa proximal hub housing 2110, an inner cutting shaft 2130 disposed withinan elongated outer shaft (not shown), and an inner core drive assembly2140. Inner core drive assembly 2140 includes a ferrule sleeve 2142fixedly engaged about inner cutting shaft 2130 and extending along aproximal portion thereof, a proximal receiver 2146, and a connector 2148including a proximal extension portion 2148 a integrally formed with orotherwise fixed relative to the body of connector 2148. Ferrule sleeve2142 is operably coupled with connector 2148 while proximal extensionportion 2148 a of connector 2148 is operably coupled with proximalreceiver 2146 (similarly as detailed above with respect to tissueresecting instrument 10 (FIGS. 1-5 )), such that rotational inputimparted to proximal receiver 2146, e.g., via drive rotor 2260 ofhandpiece assembly 2200, drives both reciprocation and rotation of innercutting shaft 2130 within and relative to the elongated outer shaft (notshown).

Continuing with reference to FIGS. 13 and 14 , proximal receiver 2146 ofinner core drive assembly 2140 is longitudinally fixed and rotatablerelative to proximal hub housing 2110 and defines a proximally-facingcavity 2147 a and a distal extension 2147 c. At least a portion ofproximally-facing cavity 2147 a has a non-circular cross-sectionalconfiguration and is configured to at least partially receive driverotor 2260 of handpiece assembly 2200 in fixed rotational orientation.Distal extension 2147 c extends distally from a closed proximal end 2147d to an open distal end 2147 e. Distal extension 2147 c defines a lumen2147 f extending between the proximal and distal ends 2147 d and 2147 e,respectively, thereof and a plurality of longitudinal slots 2147 gextending along a portion of the length of distal extension 2147 c anddefined through a side wall thereof to communicate with lumen 2147 f.Notably, a proximal portion 2147 h of distal extension 2147 c is devoidof longitudinal slots 2147 g. At least a portion of distal extension2147 c is configured to slidably receive ferrule sleeve 2142 withinlumen 2147 f thereof.

As a result of the above-detailed configuration, rotational inputimparted to proximal receiver 2146 via drive rotor 2260 rotates andreciprocates connector 2148 (wherein proximal extension 2148 a ofconnector 2148 is coupled to proximal receiver 2146 similarly asdetailed above with respect to tissue resection instrument 10 (FIGS. 1-5); this coupling is not explicitly shown in FIGS. 13 and 14 ). Due tothe operable coupling of ferrule sleeve 2142 with connector 2148(similarly as detailed above with respect to tissue resection instrument10 (FIGS. 1-5 )), rotation and reciprocation of connector 2148 relativeto proximal hub housing 2110 effects rotation and reciprocation offerrule sleeve 2142 relative to proximal hub housing 2110. With innercutting shaft 2130 fixed relative to ferrule sleeve 2142, inner cuttingshaft 2130 is also reciprocated and rotated.

A seal member 2160 is fixedly engaged about a proximal portion ofproximal extension portion 2148 a of connector 2148. Seal member 2160defines a tubular configuration that partially overlaps proximal portionof ferrule sleeve 2142 and extends proximally therefrom. Seal member2160 defines a central passageway 2162 communicating with the interiorof inner cutting shaft 2130, and an open proximal end 2164. Seal member2160, being fixedly engaged about the proximal portion of proximalextension portion 2148 a of connector 2148, is configured to rotate withconnector 2148 and translate herewith relative to proximal receiver2146.

Referring still to FIGS. 13 and 14 , in use, the motor (not shown) ofhandpiece assembly 2200 is activated to drive rotation of drive rotor2260 to, in turn, rotate proximal receiver 2146 which thereby rotatesconnector 2148. As detailed above, rotation of connector 2148 alsoresults in reciprocation of connector 2148 and, thus, rotation andreciprocation of ferrule sleeve 2142. The reciprocation and rotation offerrule sleeve 2142 is transmitted to inner cutting shaft 2130 such thatinner cutting shaft 2130 is rotated and reciprocated within and relativeto the elongated outer shaft (not shown).

With respect to the reciprocation, ferrule sleeve 2142, inner cuttingshaft 2130, and connector 2148 (including proximal extension portion2148 a thereof) are repeatedly reciprocated from respectiveproximal-most positions to respective distal-most positions and back tothe respective proximal-most positions. When proximal extension portion2148 a of connector 2148 is distally-displaced from proximal portion2147 h of distal extension 2147 c, e.g., when ferrule proximal extensionportion 2148 a of connector 2148 is sufficiently distally-displaced fromthe proximal-most position thereof, as illustrated in FIG. 13 , sealmember 2160 is displaced from distal extension 2147 c of proximalreceiver 2146 such that a fluid outflow path is defined from theinterior of inner cutting shaft 2130, through central passageway 2162and open proximal end 2164 of seal member 2160, through lumen 2147 f ofdistal extension 2147 c, through one or more of longitudinal slots 2147g of distal extension 2147 c, and to outflow conduit 2220 of handpieceassembly 2200. As such, suction applied through outflow conduit 2220 inthis position establishes vacuum within inner cutting shaft 2130 to drawcut tissue, fluid, and debris therethrough.

When proximal extension portion 2148 a of connector 2148 is disposed inor in close proximity to the proximal-most position thereof such thatseal member 2160 is at least partially disposed within proximal portion2147 h of distal extension 2147 c, an outer periphery of seal member2160 is sealed against an inner wall of proximal portion 2147 h ofdistal extension 2147 c. As noted above, proximal portion 2147 h ofdistal extension 2147 c is devoid of longitudinal slots 2147 g and,thus, the seal of seal member 2160 against the inner wall of proximalportion 2147 h of distal extension 2147 c seals off the flow path tooutflow conduit 2220 of handpiece assembly 2200. Thus, when proximalextension portion 2148 a of connector 2148 is disposed in or in closeproximity to the proximal-most position, no suction is applied throughinner cutting shaft 2130.

Referring generally to FIG. 1 , as an alternative to handpieceassemblies 200, 1200 configured for manual grasping and manipulationduring use, tissue resecting instruments 10, 1000 may alternatively beconfigured for use with a robotic surgical system wherein handlehousings 210, 1210 are configured to engage a robotic arm of the roboticsurgical system. The robotic surgical system may employ various roboticelements to assist the surgeon and allow remote operation (or partialremote operation). More specifically, various robotic arms, gears, cams,pulleys, electric and mechanical motors, etc. may be employed for thispurpose and may be designed with the robotic surgical system to assistthe surgeon during the course of an operation or treatment. The roboticsurgical system may include remotely steerable systems, automaticallyflexible surgical systems, remotely flexible surgical systems, remotelyarticulating surgical systems, wireless surgical systems, modular orselectively configurable remotely operated surgical systems, etc.

The robotic surgical system may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prep the patientfor surgery and configure the robotic surgical system with the surgicaldevice disclosed herein while another surgeon (or group of surgeons)remotely control the surgical device via the robotic surgical system. Ascan be appreciated, a highly skilled surgeon may perform multipleoperations in multiple locations without leaving his/her remote consolewhich can be both economically advantageous and a benefit to the patientor a series of patients.

The robotic arms of the robotic surgical system are typically coupled toa pair of master handles by a controller. The handles can be moved bythe surgeon to produce a corresponding movement of the working ends ofany type of surgical instrument (e.g., end effectors, graspers, knifes,scissors, cameras, fluid delivery devices, etc.) which may complementthe use of the tissue resecting devices described herein. The movementof the master handles may be scaled so that the working ends have acorresponding movement that is different, smaller or larger, than themovement performed by the operating hands of the surgeon. The scalefactor or gearing ratio may be adjustable so that the operator cancontrol the resolution of the working ends of the surgicalinstrument(s).

While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely as examplesof particular embodiments. Those skilled in the art will envision othermodifications within the scope and spirit of the claims appended hereto.

Although the foregoing disclosure has been described in some detail byway of illustration and example, for purposes of clarity orunderstanding, it will be obvious that certain changes and modificationsmay be practiced within the scope of the appended claims.

What is claimed is:
 1. An end effector assembly of a tissue resectinginstrument, the end effector assembly comprising: a housing defining anoutflow exit; an outer shaft fixed relative to and extending distallyfrom the housing; an inner shaft disposed within the outer shaft anddefining an outflow lumen therethrough; a proximal drive connectordisposed within the housing and translationally fixed relative to thehousing; a distal drive connector disposed within the housing, thedistal drive connector operably coupled to the inner shaft within thehousing and configured to translate relative to the housing and theproximal drive connector between an approximated position and aspaced-apart position to thereby translate the inner shaft relative tothe outer shaft between a proximal position and a distal position; and aseal member disposed on one of the proximal drive connector or thedistal drive connector, wherein, in the approximated position of thedistal drive connector, the seal member forms a seal between the distaldrive connector and the proximal drive connector to thereby inhibitfluid communication between the outflow lumen and the outflow exit, andwherein, in the spaced-apart position of the distal drive connector, theoutflow lumen and the outflow exit are disposed in fluid communicationwith one another.
 2. The end effector assembly according to claim 1,wherein the seal member is disposed on the proximal drive connector suchthat the seal is translationally fixed relative to the housing.
 3. Theend effector assembly according to claim 1, wherein the seal member isdisposed on the distal drive connector such that the seal is configuredto translate with the distal drive connector relative to the housing. 4.The end effector assembly according to claim 1, wherein an end face ofthe seal member is configured to establish the seal.
 5. The end effectorassembly according to claim 1, wherein an outer periphery of the sealmember is configured to establish the seal.
 6. The end effector assemblyaccording to claim 1, wherein the outer shaft defines a windowtherethrough towards a distal end thereof, the window disposed in fluidcommunication with the outflow lumen of the inner shaft.
 7. The endeffector assembly according to claim 6, wherein the inner shaft definesa distal opening that establishes fluid communication between the windowand the outflow lumen.
 8. The end effector assembly according to claim7, wherein the distal opening is an open distal end of the inner shaft.9. The end effector assembly according to claim 1, wherein the proximaldrive connector is configured to rotate relative to the housing and toimpart rotational motion to the distal drive connector to rotate thedistal drive connector relative to the housing at a same rate of speedas the rotation of the proximal drive connector.
 10. The end effectorassembly according to claim 9, wherein a gear assembly rotationallycouples the distal drive connector with the inner shaft such that, inresponse to rotation of the distal drive connector relative to thehousing, the inner shaft is rotated relative to the housing at anincreased rotation rate compared to a rotational speed of the distaldrive connector.
 11. A tissue resecting instrument, comprising: ahandpiece assembly including an outflow conduit; and an end effectorassembly, including: a housing configured to releasably engage thehandpiece assembly, the housing defining an outflow exit configured tofluidly communicate with the outflow conduit when the housing is engagedwith the handpiece assembly; an outer shaft fixed relative to andextending distally from the housing; an inner shaft disposed within theouter shaft and defining an outflow lumen therethrough; a proximal driveconnector disposed within the housing and translationally fixed relativeto the housing; a distal drive connector disposed within the housing,the distal drive connector operably coupled to the inner shaft withinthe housing and configured to translate relative to the housing and theproximal drive connector between an approximated position and aspaced-apart position to thereby translate the inner shaft relative tothe outer shaft between a proximal position and a distal position; and aseal member disposed on one of the proximal drive connector or thedistal drive connector, wherein, in the approximated position of thedistal drive connector, the seal member forms a seal between the distaldrive connector and the proximal drive connector to thereby inhibitfluid communication between the outflow lumen and the outflow exit, andwherein, in the spaced-apart position of the distal drive connector, theoutflow lumen and the outflow exit are disposed in fluid communicationwith one another.
 12. The tissue resecting instrument according to claim11, wherein the handpiece assembly includes a drive rotor configured tooperably connect to the end effector assembly to drive translation ofthe inner shaft.
 13. The tissue resecting instrument according to claim12, wherein the handpiece assembly further includes a motor configuredto drive rotation of the drive rotor.
 14. The tissue resectinginstrument according to claim 11, wherein the seal member is disposed onthe proximal drive connector such that the seal is translationally fixedrelative to the housing.
 15. The tissue resecting instrument accordingto claim 11, wherein the seal member is disposed on the distal driveconnector such that the seal is configured to translate with the distaldrive connector relative to the housing.
 16. The tissue resectinginstrument according to claim 11, wherein an end face of the seal memberis configured to establish the seal or an outer periphery of the sealmember is configured to establish the seal.
 17. The tissue resectinginstrument according to claim 11, wherein the outer shaft defines awindow therethrough towards a distal end thereof and wherein the innershaft defines a distal opening that establishes fluid communicationbetween the window and the outflow lumen.
 18. The tissue resectinginstrument according to claim 11, wherein the proximal drive connectoris configured to rotate relative to the housing and to impart rotationalmotion to the distal drive connector to rotate the distal driveconnector relative to the housing at a same rate of speed as therotation of the proximal drive connector.
 19. The tissue resectinginstrument according to claim 18, wherein a gear assembly rotationallycouples the distal drive connector with the inner shaft such that, inresponse to rotation of the distal drive connector relative to thehousing, the inner shaft is rotated relative to the housing at anincreased rotation rate compared to a rotational speed of the distaldrive connector.
 20. The tissue resecting instrument according to claim11, wherein the outflow conduit of the handpiece assembly is adapted toconnect to a source of vacuum to establish suction through the innershaft when the distal drive connector is disposed in the spaced-apartposition.